Aspirin
Severe
Textbook-cited
Hypoglycemia.
Avoid concurrent use; substitute with paracetamol if analgesic needed
Source: KDT 7e · p949
Drug reference
Glipizide
Second-generation sulfonylurea · Antidiabetic
Also known as Glucotrol, Glucotrol XL, Glynase, Minodiab
START
IR 5 mg/day before breakfast (2.5 mg elderly/renal/hepatic)
TYPICAL MAX
40 mg/day IR; 20 mg/day XL
STOP IF
Recurrent/severe hypoglycaemia, significant hepatic or renal decline, pregnancy
WATCH
Hypoglycaemia (esp. elderly/renal), HbA1c, weight, hepatic/renal function
CDSCO approvedSchedule HJan AushadhiATC A10BB07
KDIGO 2024 + manufacturer label
- ONSET
- 30min · glucose-lowering onset
- PEAK
- 2h · Cmax (IR)
- t½
- 4h · plasma t½
- DURATION
- 18h · effect duration
EXCRETION
Hepatic CYP2C9; ~80% renal inactive metabolites
route + CYP
INTERACTIONS
12 major
SEVERE in our sources
PREGNANCY
Avoid — use insulin in pregnancy; neonatal hypoglycaemia if used near term
FDA category + note
Top interactionssee all 12 →
- AspirinSevereTextbook-citedKDT 7e · p949
- AtazanavirSevereTextbook-citedKDT 7e · p948
- CarbamazepineSevereTextbook-citedKDT 7e · p949
- CelecoxibSevereTextbook-citedKDT 7e · p949
Available in India
45 branded formulations. Look up specific brands in the Drugs workspace.
Jan Aushadhi — generic available at GoI pharmacies
Mechanism
Closes pancreatic beta-cell ATP-sensitive K+ channels (SUR1), depolarising the cell and triggering calcium-dependent insulin secretion; insulin-secretagogue requiring functioning beta cells.
Indications
Type 2 diabetes mellitus (adjunct to diet/exercise, often add-on to metformin)
Dosing
- Adult
- IR: 5 mg PO once daily 30 min before breakfast; titrate by 2.5–5 mg; doses >15 mg/day divided; max 40 mg/day. XL: 5 mg/day with breakfast, max 20 mg/day.
- Pediatric
- Not established.
- Renal adjustment
- Use with caution; preferred over glibenclamide (shorter-acting metabolites). Start low, avoid in severe impairment.
- Hepatic adjustment
- Start 2.5 mg; avoid in severe impairment.
- Geriatric
- Start 2.5 mg/day; heightened hypoglycaemia risk (Beers caution — prefer shorter-acting SU).
- Max dose
- 40 mg/day (IR); 20 mg/day (XL)
Pharmacokinetics
Onset
~30 min
Peak effect
1–3 h (IR)
Duration
12–24 h
Half-life
~2–5 h
Bioavailability
Nearly complete (delayed by food — take before meals for IR)
Protein binding
~98–99%
Metabolism
Hepatic (CYP2C9) to inactive metabolites
Excretion
Renal (~80% as inactive metabolites)
Contraindications
- Type 1 diabetes / diabetic ketoacidosis
- Severe hepatic or renal impairment (hypoglycaemia risk)
- Sulfonylurea/sulfonamide hypersensitivity
- Pregnancy (use insulin)
Side effects
Common
HypoglycaemiaWeight gainNausea/GI upsetDizziness
Serious
- Severe/prolonged hypoglycaemia (esp. elderly, renal/hepatic impairment)
- Haemolytic anaemia (G6PD deficiency)
- Cholestatic jaundice (rare); SIADH/hyponatraemia
- Severe skin reactions (rare)
Pregnancy & lactation
Pregnancy
Avoid — use insulin in pregnancy; neonatal hypoglycaemia if used near term
Lactation
Avoid — risk of infant hypoglycaemia
Drug interactions
Atazanavir
Severe
Textbook-cited
Hypoglycemia
Avoid concurrent use or adjust dose
Source: KDT 7e · p948
Carbamazepine
Severe
Textbook-cited
Loss of glycemic control; hyperglycemia.
Increase sulfonylurea dose or switch to non-interacting agent
Source: KDT 7e · p949
Celecoxib
Severe
Textbook-cited
Hypoglycemia.
Avoid concurrent use; substitute with paracetamol if analgesic needed
Source: KDT 7e · p949
Chloramphenicol
Severe
Textbook-cited
Hypoglycemia
Monitor blood glucose; reduce sulfonylurea dose
Source: KDT 7e · p949
Clarithromycin
Severe
Textbook-cited
Hypoglycemia.
Avoid concurrent use or adjust dose
Source: KDT 7e · p948
Cotrimoxazole
Severe
Textbook-cited
Hypoglycemia
Avoid concurrent use; if needed, monitor blood glucose closely
Source: KDT 7e · p948
Darunavir
Severe
Textbook-cited
Hypoglycemia
Avoid concurrent use or adjust dose
Source: KDT 7e · p948
Diclofenac
Severe
Textbook-cited
Hypoglycemia.
Avoid concurrent use; substitute with paracetamol if analgesic needed
Source: KDT 7e · p949
Erythromycin
Severe
Textbook-cited
Hypoglycemia.
Avoid concurrent use or adjust dose
Source: KDT 7e · p948
Ibuprofen
Severe
Textbook-cited
Hypoglycemia.
Avoid concurrent use; substitute with paracetamol if analgesic needed
Source: KDT 7e · p949
Indomethacin
Severe
Textbook-cited
Hypoglycemia.
Avoid concurrent use; substitute with paracetamol if analgesic needed
Source: KDT 7e · p949
Related guidelines
Fluid and electrolyte management in diabetes
RSSDI · Endocrinology · 2025
Diabetes management during Ramadan
ADA · Endocrinology · 2025
Glucose monitoring in diabetes
RSSDI · Endocrinology · 2024
Gestational diabetes mellitus
FOGSI · Obstetrics & Gynaecology · 2023
Type 2 diabetes in adults
ICMR · Endocrinology · 2022
Ask House about Glipizide
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: KD Tripathi 7e, Goodman & Gilman 14e, Katzung, BNF·Verified: 2026-05-19 · House clinical team·Cockpit curated: 2026-05-19